AttachmentH-Conflict-of-InterestAffidavit.pdf

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Attached to
Supply & Installation of Fire Pump
Solicitation number
BPM042268
Issued by
Washington County, Maryland

About this file

The document is an Attachment H - Conflict of Interest Affidavit pertaining to a state and local contract opportunity for the Supply & Installation of Fire Pump and Control Panel for the Western Maryland Hospital Center in Washington County, Maryland. The affidavit requires the offeror to disclose any actual or potential conflicts of interest and to agree to notify the procurement officer of any such conflicts that may arise in the future. The contract opportunity involves the supply and installation of a fire pump and control panel for use by the Western Maryland Hospital Center.

The affidavit does not provide any additional details about the pricing terms, set asides, incumbent, funding requirements and sources, or other salient information related to the contract opportunity. The affidavit solely focuses on conflict of interest disclosure and reporting requirements.

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Other files

File Type Posted
Approved Bid Page.docx DOCX document
Attachment-N- Contract Affidavit.pdf PDF
Approved Fire Pump Small Procurement Invitation for Bid.docx DOCX document

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Text version

Attachment H – Conflict of Interest Affidavit Page H-1 effective date: April 17, 2018

Attachment H. Conflict of Interest Affidavit and Disclosure

Reference COMAR 21.05.08.08

A. “Conflict of interest” means that because of other activities or relationships with other persons, a person is unable or potentially unable to render impartial assistance or advice to the State, or the person’s objectivity in performing the contract work is or might be otherwise impaired, or a person has an unfair competitive advantage.

B. “Person” has the meaning stated in COMAR 21.01.02.01B (64) and includes a Offeror, Contractor, consultant, or subcontractor or sub-consultant at any tier, and also includes an employee or agent of any of them if the employee or agent has or will have the authority to control or supervise all or a portion of the work for which a Proposal is made.

C. The Offeror warrants that, except as disclosed in §D, below, there are no relevant facts or circumstances now giving rise or which could, in the future, give rise to a conflict of interest.

D. The following facts or circumstances give rise or could in the future give rise to a conflict of interest (explain in detail — attach additional sheets if necessary):

E. The Offeror agrees that if an actual or potential conflict of interest arises after the date of this affidavit, the Offeror shall immediately make a full disclosure in writing to the procurement officer of all relevant facts and circumstances. This disclosure shall include a description of actions which the Offeror has taken and proposes to take to avoid, mitigate, or neutralize the actual or potential conflict of interest. If the contract has been awarded and performance of the contract has begun, the Contractor shall continue performance until notified by the procurement officer of any contrary action to be taken.

I DO SOLEMNLY DECLARE AND AFFIRM UNDER THE PENALTIES OF PERJURY THAT THE

CONTENTS OF THIS AFFIDAVIT ARE TRUE AND CORRECT TO THE BEST OF MY

KNOWLEDGE, INFORMATION, AND BELIEF.

Date: ____________________ By: ______________________________________

(Authorized Representative and Affiant)

SUBMIT THIS AFFIDAVIT WITH BID/PROPOSAL

Attachment H. Conflict of Interest Affidavit and Disclosure

File details come from the government source that posted it. Updated .